We're From The Government and We're Here To Help You

This spring ARRA committed $20B toward electronic medical records. Physician's who implemented EMR's in a meaningful could qualify for reimbursement toward their investment. Problem was and still is the government has yet to define meaningful use. So theoretically while the ARRA $20B was intended to stimulate the economy its effect has been quite the opposite. Spending on EMR's has evaporated as Doctors have waited for meaningful use to be defined before they invested any money. They are still waiting. Many small businesses that have been providing IT support for physicians including speech recognition paired with EMR's to boost practice productivity and profitability have experienced sales just ceasing.

In today's headlines we learn the cash for clunkers program has no money left. We spent $1B, it worked and $1B more has been allocated but who knows how long that will last so its going to be stopped. Moreover know one bothered to work out the details on how the program would be administered. Welcome to the train wreck. We bailout GM and they send $1Billion to Brazil while laying off 10,000 American citizens and this happens while we have a car czar

If the government cannot handle a few $billion for cash for clunkers what makes you think there is any hope for smooth sailing for a $trillion healthcare reform? No complexity there, right?

The history of federal intervention in Health Care whether its Medicare, Medicaid, Medicare Part D shows a pathetic track record at predicting costs which have been underestimated at an appalling rate.

Its time to visit your congress mans town hall and be heard on health care reform.

Helpful Links For Spendulus Package

[Official Guidance] American Recovery and Reinvestment Tax Act of 2009: Conference Report (PDF) 577 pages. COBRA provisions start on page 396. (U.S. House of Representatives)

[Guidance Overview] Immediate Action Needed to Implement Stimulus Act Changes to COBRA Coverage 7 pages; excellent. Excerpt: "[D]ecisions and procedures include . . . . Identifying all potential [assistance-eligible individuals, or 'AEIs') -- employees who were covered by the group health plan whose employment was involuntarily terminated (other than for gross misconduct) beginning September 1, 2008 (and their covered spouses and dependents) -- and their last known addresses; Identify which of these individuals are AEIs currently receiving COBRA coverage and which are entitled to the special enrollment period; Adopting the method when developed by the Secretary of Treasury for permitting 'high-income individuals' to permanently waive the premium subsidy. . . . ."

(Butzel Long) [Guidance Overview] American Recovery and Reinvestment Act of 2009 Affects Group Health Plans, Even If Fewer Than 20 Employees Excerpt: "The Act provides a subsidy for COBRA coverage and imposes a number of requirements on employers, administrators and insurers. This bulletin summarizes the subsidy as well as the enrollment provisions, notice requirements and employer filing requirements established by the Act. . . . The Act's provisions apply to coverage under both the federal COBRA law and any state 'mini-COBRA' laws (i.e., state continuation laws applicable to employers with fewer than 20 employees). "

(Thompson Hine) [Guidance Overview] Stimulus Package Includes 65% COBRA Premium Subsidy Excerpt: "Although the Act omits language from the House bill that would have mandated an extension of COBRA coverage through age 65, it does require employers and other plan sponsors to facilitate this federal subsidy of COBRA premiums. The subsidy will cover 65% of the monthly premium, for a period of up to nine months."

(Spencer Fane) [Guidance Overview] New Federal Laws Affecting Group Health Plans (PDF) 5 pages. Excerpt: "This bulletin provides a summary of two federal laws that will impact group health plans. The American Recovery and Reinvestment Act of 2009 has been passed by the House, and is expected to be passed by the Senate and signed by President Obama no later than Presidents' Day. The Children's Health Insurance Program Reauthorization Act of 2009 was signed into law on February 4, 2009."

(Thompson Hine LLP) [Guidance Overview] H.R. 1 Contains COBRA Provisions Excerpt: "Looks like that huge stimulus package has some COBRA provisions in it, after all. The U.S. House of Representatives, on a largely party line 246-183 vote, approved legislation that includes a provision that would provide a 65% federal COBRA premium subsidy for nine months for employees who are laid off between September 1, 2008, and December 31, 2009. According to Business Insurance, the legislation would, among other things, require employers to locate employees laid off since September 1, 2008, who declined COBRA to tell them they have a new right to opt for the coverage - with the government picking up 65% of the premium."

(PLANSPONSOR.com; free registration required) Employers Prepare for Surge in COBRA Enrollees Excerpt: "Employers will have to scramble to comply with federal legislation providing a federal subsidy of COBRA health insurance premiums to laid-off employees. Employees who were laid off from Sept. 1, 2008, through Dec. 31, 2009, will be eligible for a 65% federal subsidy of their COBRA premiums under provisions in the massive economic stimulus bill."

(Business Insurance) 'Evidence-Based Medicine': Rationing Care and Hurting Patients (PDF) 16 pages. Excerpt: "At first glance, this concept seems to make sense. Any term with the word 'evidence' automatically confers a sense of scientific authority. Assuming that to be true, the United States Congress and some state legislatures have begun adding 'evidence-based' requirements to health care laws. Several laws even link physician payment for medical services to compliance with EBM in an initiative called 'pay for performance.' Of concern to patients and doctors, the terms 'evidence-based medicine' and 'evidence-based guidelines' are often not defined in these laws, access to individualized care is not preserved, and the integrity of medical decisionmaking has not been protected."

(American Legislative Exchange Council) Assessing the Future Basis of Drug Pricing (PDF) 2 pages. (Milliman)